Teru Kassner

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT000572 Issued in GA

Practice address

536 Grand Slam Dr
Evans, GA 30809-8044

Phone

(706) 854-8434

Fax

(706) 854-8435

NPI assigned

Jan 26, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Therapy Trails of Evans

  • Multi-Specialty Clinic/Center
  • Evans, GA
  • NPI 1124677919
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1457599672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098044",
            "telephone_number": "706-854-8434",
            "fax_number": "706-854-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 GRAND SLAM DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308098044",
            "telephone_number": "706-854-8434",
            "fax_number": "706-854-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSNER",
        "first_name": "TERU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT000572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "514940185A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Kale, DPT
• Kathy B Kallmann, LPC
• Clint Karamath Jr., DC
• Fanta Elizabeth Kasiah, M.D.
• Srinivasa Venkata Siva Kumar Kasina, MBBS
• Katie Nelson, LPC, LLC
• Lakeshia Mae Kauffman, ABOC, NCLEC, LDO
• Poonaminder Kaur, MD
• James Benjamin Kay IV, M.D.
• Emma K Keeler, PA

• All providers in Evans, GA
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.